Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mountlake Sports & Physical Therapy Ps

Organization Physical Therapist · NPI 1528331402

Mountlake Sports & Physical Therapy Ps is a Physical Therapist in Everett, Washington. Licensed in Washington. Registered with an NPI since 2012.

Licensed in
WA
In the registry since
2012
Specialties on file
4
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Practice location Address checks out

9505 19th Ave SE 101
Everett, WA 98208-3853
Phone: (425) 379-8120
Fax: (425) 338-1789
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT00003917 (WA)
Physical Therapist Taxonomy 225100000X · Licence PT60178380 (WA)
Massage Therapist Taxonomy 225700000X · Licence MA00018299 (WA)
Massage Therapist Taxonomy 225700000X · Licence MA00015079 (WA)

Record details

NPI number1528331402
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jamie Malijan — Clinical Manager · (425) 379-8120
NPI enumeratedFebruary 22, 2012
Last updated in NPPESFebruary 22, 2012
Mailing address9505 19th Ave Se, 101, Everett, WA 98208-3853

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